So I was glad to see Andrew Sullivan revisitThe Road to Serfdom to see whether Hayek addressed the topic of health care that so captivates America these days. Hayek did, it turns out, and I had forgotten.

(Recall that I, also with classical liberal instincts, concluded, in my amateurish way, that health care is different enough from other industries to warrant one of two clean and equally acceptable solutions: universal private insurance or universal government–ie, “single-payer” insurance. Anything, in short, but America’s current, fragmented, employer-government-individual hodgepodge.)

Here is Hayek, from Chapter 9 of The Road to Serfdom, via Andrew:

Nor is there any reason why the state should not assist the individuals in providing for those common hazards of life against which, because of their uncertainty, few individuals can make adequate provision…. Where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance – where, in short, we deal with genuinely insurable risks – the case for the state’s helping to organize a comprehensive system of social insurance is very strong… Wherever communal action can mitigate disasters against which the individual can neither attempt to guard himself nor make the provision for the consequences, such communal action should undoubtedly be taken.

3 thoughts on “Hayek on healthcare: Don’t be serfs, Americans!”

I happened (stumbled) upon an interview Charles Krauthammer did with Der Spiegel. About the healthcare problem in America, Krauthammer said:

I would make Americans pay half a percent tax on their health insurance and create a pool to socialize the cost of medical errors. That would save hundreds of billions of dollars that could be used to insure the uninsured. And second, I would abolish the absurd prohibition against buying health insurance in another state — that reduces competition and keeps health insurance rates artificially high.

And

It is absolutely crazy that in America employees receive health insurance from their employers — and at the same time a tax break for this from the federal government. It’s a $250 billion a year loophole in the government’s budget. If you taxed healthcare benefits, you would have enough revenue for the government to give back to the individual to purchase their own insurance. If you did those two reforms alone, you would have the basis for affordable health insurance in America.

Not living in America, I haven’t followed the healthcare debate (it’s so , like, boring), hence I don’t know if what Krauthammer said is news or not.

The problem with Krauthammer’s comments is that they are ideas to fix the existing dysfunctional system while creating new bureaucracies. And it perpetuates the use of the tax code to promote social engineering. The best solution is a total rework of the system from ground zero.

Aside from providing quality affordable health care for everyone, the system should also be gentle on the elderly and others and shopping around for the best interstate deal on health care on the internet is not something people should have to do.

I think the main contribution of Hayek here might be simply to take our fear away from any solution that has the world “government” or “public” (as in: “public option”) attached to it. Contemporary American Republicans often get semantically confused, thinking that anything containing these words must smack of serfdom. Hayek, who literally wrote the book on serfdom and its opposite, reminds us that government is not always an enemy of freedom.